Obesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directions

Abstract

Obesity markedly increases the risk of benign prostatic hyperplasia. Since physical activity decreases the risk of benign prostatic hyperplasia, these observations support the development of novel prevention strategies and treatment targeted toward adiposity, weight loss and lifestyle.

Lifestyle factors, benign prostatic hyperplasia, and lower urinary tract symptoms

“…A majority of studies, involving tens of thousands of men, have noted that obesity is associated with increased risks of both BPH and LUTS [10 ]. Recent studies include a 7-year prospective analysis of 5700 men participating in the Prostate Cancer Prevention Trial (PCPT) [11], an investigation of 21 700 Norwegian men in the second Nord-Trøndelag Health Study (HUNT-2) [12], and a cohort study of 2800 men in the National Health and Nutrition Examination Survey (NHANES III) [13].…”

“…Obesity has also been associated with prostate enlargement: in the BLSA, obese (BMI !35 kg/m 2 ) participants had a 3.5-fold increased risk of prostate enlargement compared to nonobese (BMI <25 kg/m 2 ) participants [9]. A recent analysis of more than 16 000 radical prostatectomy specimens validated these findings, observing that each 1 kg/m 2 increase in preoperative BMI was associated with a 0.45 g (95% CI 0.35-0.55 g) increase in total prostate weight (P trend <0.001) and a 70% increased risk of prostate enlargement comparing obese to nonobese men [odds ratio (OR) 1.70, 95% CI 1.32-2.20] (J.K. Parsons and M. Han, unpublished data).A majority of studies, involving tens of thousands of men, have noted that obesity is associated with increased risks of both BPH and LUTS [10 ]. Recent studies include a 7-year prospective analysis of 5700 men participating in the Prostate Cancer Prevention Trial (PCPT) [11], an investigation of 21 700 Norwegian men in the second Nord-Trøndelag Health Study (HUNT-2) [12], and a cohort study of 2800 men in the National Health and Nutrition Examination Survey (NHANES III) [13].…”

Laparoscopic sleeve gastrectomy effects on overactive bladder symptoms

“…Most available data are for women but obese men also experience urinary disorders, as evidenced by our results and the Epi-LUTS study. Obesity markedly increases the risk of benign prostatic hyperplasia, which is responsible for voiding and storage symptoms; physical activity decreases the risk of benign prostatic hyperplasia [32]. The onset of storage symptoms secondary to bladder outlet obstruction is common in both men and women.…”

Association of variants in genes related to the immune response and obesity with BPH in CLUE II

“…1 The precise mechanisms by which these factors may influence this complex condition are not well-understood, but several lines of evidence suggest that risk of BPH and LUTS could be increased by chronic inflammation 2 and obesity-associated perturbations in energy and insulin regulation. 3 More specifically, cytokines and reactive species elaborated during a chronic inflammatory state may damage prostate cell membranes and DNA leading to increased cellular replication to replaced damage cells, and thus increasing the risk of hyperplasia. 4 Obesity is also a state of increased oxidative stress and the metabolic perturbations that accompany obesity tend to be growth-promoting, again possibly leading to hyperplasia and increased risk of BPH.…”